Foot + Ankle Pathologies

Reiter Syndrome: affects the sacroiliac joints and lower limbs of young men; the radiographic hallmark is a specific area of bony erosion at the Achilles tendon insertion on the posterior superior margin of the calcaneus. Involvement is usually bilateral, and arthritis, urethritis and conjunctivitis are characteristic of this syndrome. Reiter syndrome is caused by a previous infection of the gastrointestinal tract such as salmonella or by a sexually transmitted infection.

Osteomalacia (Rickets): literally means "bone softening"/ This disease is caused by lack of bone mineralization secondary to a deficiency of calcium, phosphorus or vitamin D in the diet or an inability to absorb these minerals. Because of the softness of the bones, bowing defects in weight-bearing parts often result. This disease is known as rickets in children and commonly results in bowing of the tibia.

Osteoid osteomas: Benign bone lesions that usually occur in teenagers or young adulthood. Symptoms include localized pain that typically worsens at night but is relieved by over-the-counter anti-inflammatory or pain medications. The tibia and femur are the most likely locations of these lesions.

Osgood-Schlatter disease: involves inflammation of the bone and cartilage of the anterior proximal tibia is most common in boys aged ten to fifteen years old. The cause is believed to be an injury that occurs when the large patellar tendon detaches part of the tibial tuberosity to which it is attached. Severe cases may require immobilization by a plaster cast.

Lisfranc Joint Injury: Lisfranc ligament is a large band that spans the articulation of the media cuneiform and the first and second metatarsal base. These range from sprains to fracture-dislocations of the bases of the first and second metatarsals. A moderate sprain of the Lisfranc ligament is characterized by an abnormal separation between the first and second metatarsals. A small avulsion fracture may indicate more severe injury. Lisfranc join injuries may be missed if weight-bearing AP and lateral foot projections are not performed.

Gout: a form of arthritis that may be hereditary in which uric acid appears in excessive quantities in the blood and may be deposited in the joints and other tissues. Common initial attacks occur in the first MTP joint of the foot. Later attacks may occur in other joints such as the first MCP joint of the hand but generally these are not evident radiographically until more advanced conditions develop. Most cases occur in men and first attacks rarely occur before the age of thirty.